Acombination of text messages and individual counselling sessions to motivate patients with rheumatoid arthritis may lead to improved patient outcomes, scientists have found for the first time.

This type of behavioural intervention was effective at reducing daily sitting time by an average of more than two hours in rheumatoid arthritis (RA) patients, and also reduced their cholesterol levels.

Due to their disease, patients with RA tend to be more sedentary than the general population, which can have serious health consequences, including an increased risk of cardiovascular disease and premature death.

Patients with RA already have an increased risk of cardiovascular disease and premature death, partly caused by the chronic inflammatory rheumatic disease itself, and partly by traditional risk factors, such as hyperlipidaemia.

lthough exercise is known to have a positive effect on pain and physical functioning in patients with RA, pain often acts as a barrier against maintenance of a physically active lifestyle.

more feasible approach for improving health and well-being in RA patients would therefore be to focus on reducing sedentary behaviour and increasing light intensity activity, rather than solely concentrating on increasing moderate and vigorous physical activity.

"We know that behavioural approaches are effective in reducing sedentary behaviour in healthy populations," said Tanja Thomsen of the Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases in Denmark.

"Our findings support the introduction of behavioural approaches as an effective way to improve the health of rheumatoid arthritis patients, which may also be applicable in other populations with chronic disease and limited mobility," Thomsen added.

As many as 75 adult RA patients with a self-reported daily sitting time greater than five hours and Health Assessment Questionnaire score less than 2.5 underwent a 16-week individually tailored, behavioural intervention that included three individual motivational counselling sessions with a health professional and regular text messages aimed at improving motivation to reduce daily sitting time and replacing it with light intensity physical activity.

Providing an online therapy may be a more effective treatment for anxiety and depression than usual primary care, scientists have found.

Researchers at the University of Pittsburgh in the US enrolled 704 depressed and anxious patients who were between 18 to 75 years old.

They showed that providing an online computerised cognitive behavioural therapy (CCBT) programme both alone and in combination with Internet Support Groups (ISG) provided better outcomes for patients.

The participants were randomised to one of three groups: care manager-guided access to the eight-session Beating the Blues CCBT programme; care manager-guided access to both the CCBT programme and a password-protected ISG patients could access 24/7 via smartphone or desktop computer; or usual behavioural health care from their primary care physician.

Over the six-month intervention, 83 per cent of patients randomised to CCBT started the programme, and they completed an average of 5.3 sessions.

Seventy-seven per cent of patients assigned to the ISG logged into the site at least once, and 46 per cent provided one or more posts or comments.

Six months later, those patients randomised to CCBT reported significant improvements in their mood and anxiety symptoms and the more CCBT sessions patients completed, the greater the improvement in mood and anxiety symptoms.

Although patients randomised to both CCBT and ISG had similar overall improvements in mood and anxiety symptoms compared to patients randomised to only CCBT, secondary analysis showed those who engaged more with the ISG tended to experience greater improvements in symptoms.

ISG that enable individuals with similar conditions to access and exchange self-help information and emotional support have proliferated in recent years, but benefits have yet to be established in randomised trials, researchers said.

"Our study findings have important implications for transforming the way mental health care is delivered," said Bruce L Rollman, professor at the University of Pittsburgh.

"Providing depressed and anxious patients with access to these emerging technologies may be an ideal method to deliver effective mental health treatment, especially to those who live in areas with limited access to care resources or whohave transportation difficulties or work/home obligations that make in-person counselling difficult to obtain," he said.

Parents should have lessons provided by the government on how to raise their children, Britain's leading public health expert has said.

Professor John Ashton, outgoing president of the Faculty of Public Health (FPH), said children were neglected by some schools and parents.

He said the state should help stop children being crippled by conditions such as anxiety, anorexia and obesity.

The FPH has released a report calling for mental health improvements.

It says: "Mental, emotional or psychological problems account for more disability than all physical health problems put together.

"Although we cannot say yet exactly how much of the burden of mental illness could be prevented, we know prevention is possible."

Human cost

One in 10 children aged five to 16 years had a mental health problem that warranted support and treatment, the report said.

And the quality of the parent-child relationship and parenting more broadly played a primary role.

Prof Ashton said that, given the huge financial and human cost of mental health problems, more should be done to tackle their causes.

He said: "We've done well in terms of producing live, healthy babies over the last 60, 70 years, but, by the time children are leaving school, between 10% and 15% of them are in trouble emotionally or mentally, and suffer from things like obesity, eating disorders, anxiety and stress.

"Having produced healthy babies we then set about neglecting them."

Prof Ashton suggested parenting advice and support could be provided by investing in existing networks - such as health visitors and schools. And by using social media to reach parents and setting up 24/7 helplines - for example for people raising adolescents.

Parenting key

Prof Sarah Stewart-Brown, who produced the report, said diet and activity played a role in mental health but "supporting parenting is key. The first 1,001 days of a child's life are particularly important.

"Over three-quarters of all mental health problems emerge in childhood and adolescence."

Programmes based in schools, workplaces, doctors' surgeries, and in the community could help, she said.

The Faculty of Public Health sets standards for public health specialists in the UK and covers 3,300 professionals.

Whether you're Van Gogh or a stick-figure sketcher, a new Drexel University study found that making art can significantly reduce stress-related hormones in your body.

Although the researchers from Drexel's College of Nursing and Health Professions believed that past experience in creating art might amplify the activity's stress-reducing effects, their study found that everyone seems to benefit equally.

"It was surprising and it also wasn't," said Girija Kaimal, EdD, assistant professor of creative arts therapies. "It wasn't surprising because that's the core idea in art therapy: Everyone is creative and can be expressive in the visual arts when working in a supportive setting. That said, I did expect that perhaps the effects would be stronger for those with prior experience."

The results of the study were published in Art Therapy under the title "Reduction of Cortisol Levels and Participants' Responses Following Art Making." Kendra Ray, a doctoral student under Kaimal, and Juan Muniz, PhD, an assistant teaching professor in the Department of Nutrition Sciences, served as co-authors.

"Biomarkers" are biological indicators (like hormones) that can be used to measure conditions in the body, such as stress. Cortisol was one such the hormone measured in the study through saliva samples. The higher a person's cortisol level, the more stressed a person is likely to be.

For Kaimal's study, 39 adults, ranging from 18 to 59 years old, were invited to participate in 45 minutes of art-making. Cortisol levels were taken before and after the art-making period.

Materials available to the participants included markers and paper, modeling clay and collage materials. There were no directions given and every participant could use any of the materials they chose to create any work of art they desired. An art therapist was present during the activity to help if the participant requested any.

Of those who took part in the study, just under half reported that they had limited experience in making art.

The researchers found that 75 percent of the participants' cortisol levels lowered during their 45 minutes of making art. And while there was some variation in how much cortisol levels lowered, there was no correlation between past art experiences and lower levels.

Written testimonies of their experiences afterward revealed how the participants felt about the creating art.

"It was very relaxing," one wrote. "After about five minutes, I felt less anxious. I was able to obsess less about things that I had not done or need [ed] to get done. Doing art allowed me to put things into perspective."

However, roughly 25 percent of the participants actually registered higher levels of cortisol -- though that wasn't necessarily a bad thing.

"Some amount of cortisol is essential for functioning," Kaimal explained. "For example, our cortisol levels vary throughout the day -- levels are highest in the morning because that gives us an energy boost to us going at the start of the day. It could've been that the art-making resulted in a state of arousal and/or engagement in the study's participants."

Kaimal and her team believed, going into the study, that the type of art materials used by participants might affect cortisol levels. They thought that the less-structured mediums -- using clay or drawing with markers -- would result in lower cortisol levels than the structured -- collaging. That, however, wasn't supported by the results, as no significant correlation was found.

The study did find a weak correlation between age and lower cortisol levels. Younger participants exhibited consistently lower cortisol levels after they'd created art.

Those results made Kaimal wonder about how young college students and high school students deal with the stress that comes from academia -- and how creative arts can help.

"I think one reason might be that younger people are developmentally still figuring out ways to deal with stress and challenges, while older individuals -- just from having lived life and being older -- might have more strategies to problem-solve and manage stress more effectively," Kaimal said.

In light of that, Kaimal plans to extend the study to explore whether "creative self- expression in a therapeutic environment can help reduce stress." In that study, other biomarkers like alpha amylase and oxytocin will also be measured to give a more comprehensive picture.

Additionally, Kaimal also plans to study how visual arts-based expression affects end-of-life patients and their caregivers.

"We want to ultimately examine how creative pursuits could help with psychological well-being and, therefore, physiological health, as well," she said.

A new study shows that children judge us on our looks – and beauty wins out on trustworthiness ratings

by Abigail Pattenden, Frontiersin.org

Is beauty only skin deep? Children don’t seem to think so, like adults and babies, children think the uglier you are, the less trustworthy you are.

In a study recently published in Frontiers in Psychology, researchers have found that as children, how we perceive someone’s trustworthiness is linked to how attractive we find them. Our ability to make this trustworthiness judgement develops as we grow, becoming more consistent as we approach adulthood, and, girls are better at it than boys.

Many psychology studies have proven the existence of the so-called “beauty stereotype”. This describes the phenomenon whereby more attractive people are also considered to be smarter, more sociable and more successful. To be attractive is to be treated better by your peers, and preferred by new-born babies, than uglier people.

People use facial cues to make judgements on a person’s character – and this ability to infer social traits is a crucial part of social functioning and development. Although well researched in babies and adults, the development of this ability in children was not previously known.

Understanding this process paints a more complete picture of this development from birth through to adulthood. It also adds to a growing body of work showing that attractiveness is a universal language when it comes to that all-important first impression.

Dr Fengling Ma and Dr Fe Xu of Zhejiang Sci-Tech University, and Dr Xiaming Lu of Wenzhou Medical University, China, assessed 138 participants – groups of children aged eight, ten and 12 years old, and compared them to a group of adults.

They used a face generation program (FaceGen) to produce 200 images of male faces – all with a neutral expression and direct gaze. In the first of two sessions, each participant was shown each face, and asked to rate how trustworthy they thought that person was. A second session followed a month later where participants repeated the exercise, this time rating the attractiveness of the same faces.

The study analysed the responses of the children and adult control groups. The researchers looked firstly at the ratings of trustworthiness, and level of agreement of the ratings within and between the groups. Did the children within the same age groups agree on how trustworthy each of the faces was?

Did the responses of the different age groups agree with each other, and with the adult group? They found that the level of agreement within and between the age groups and the adult group increased with age. From this they were able to infer that the children’s ability to judge trustworthiness therefore also increased with age.

Next, the researchers looked at the ratings of trustworthiness and attractiveness given to each face. They found a strong, direct relationship between the two traits – the faces deemed more trustworthy were also considered to be more attractive. This relationship also strengthened with age, and reveals that, like adults, children also look to a person’s attractiveness as an indication of their character.

So, it appears that judging a book by its cover, however incorrectly, is something we are born to do.